Identifying and relieving asynchrony during mechanical ventilation

Abstract

Patient–ventilator asynchrony refers to the uncoupling between the mechanically delivered breath and the patient’s respiratory effort. It is common during assisted mechanical ventilation and may affect the morbidity of critically ill patients. Close inspection of pressure, volume and flow waveforms – displayed by modern ventilators – may help the physician to recognize and act appropriately to minimize patient–ventilator asynchrony. During the last two decades new modes of assisted mechanical ventilation have been introduced, aiming to improve patient ventilator synchrony by modulating the triggering function and the variables that control the flow delivery and the cycling off.